Peptic Ulcer Disease

Vocabulary flashcards covering the etiology, pathophysiology, pathology, clinical distinctions, complications, and diagnostic testing for acute and chronic peptic ulcer disease.

Peptic Ulcer

An ulcer bathed in acid ($\text{HCl}$), commonly occurring in the duodenum, stomach, jejunum (in ZES and gastrojejunostomy), lower esophagus (in GERD), or terminal ileum (in Meckel's diverticulum containing heterotopic gastric epithelium).

Cushing's Ulcer

An acute stress peptic ulcer that occurs after cerebral trauma.

Curling's Ulcer

An acute stress peptic ulcer that develops secondary to major burns.

Cooper's Theory

A mechanism for gastric ulcer pathogenesis stating that duodeno-gastric reflux increases the destruction and devitalization of gastric mucosa.

Dragstedt Theory

A theory of gastric ulcer pathogenesis where antral stasis promotes mucosal destruction.

Helicobacter pylori

A gram-negative bacillus adherent to the antral mucosa that damages tissue by producing urease (hydrolyzing urea to $CO_2$ and alkaline ammonia) and proteases (degrading the protective mucus layer).

Ischaemic Theory

A contributing factor in gastric ulcer formation wherein reduced blood supply diminishes mucosal reconstruction, seen in elderly atherosclerotic patients and those with ischemic heart disease (IHD).

Bulbar Ulcer

The most common chronic peptic ulcer, located on the antero-superior aspect of the first inch of the first part of the duodenum at the impact site of antral jets.

Ulcer-Bearing Area (Stomach)

The lesser curvature of the stomach, predisposed to ulceration due to repeated food trauma and lower vascularity relative to the greater curvature.

Hour-Glass or Tea-Pot Stomach

A stenotic anatomical deformity of the stomach that develops as a chronic complication of a gastric ulcer.

Pyloric Stenosis

A chronic complication of duodenal ulceration leading to gastric outlet obstruction.

Pointing Sign

A physical exam sign where the patient can precisely localize the point of maximum epigastric pain with their finger.

Hunger Pain

A burning epigastric pain typical of duodenal ulcer that appears $2\,\text{hours}$ after eating (when the stomach is empty) or $1/2\text{--}1\,\text{hour}$ before meals, and frequently awakens the patient at midnight.

Periodicity

The clinical pattern characteristic of duodenal ulcers where episodes of pain occur during spring, winter, and autumn, interspersed with symptom-free periods of $2\text{--}6\,\text{months}$.

Wilkie's Triad

The clinical triad consisting of chronic cholecystitis, peptic ulcer, and appendicitis.

Saint's Triad

The clinical triad consisting of chronic cholecystitis, hiatus hernia (H.H.), and colonic diverticulosis.

Zollinger-Ellison's Syndrome (ZES)

A gastrin-hypersecreting condition presenting with multiple, recurrent, or treatment-resistant peptic ulcers in atypical sites (distal duodenum or proximal jejunum), confirmed by serum gastrin levels $> 500\,\text{pg/ml}$.

Urease Test

A diagnostic procedure for Helicobacter pylori in which a biopsy from the ulcer is combined with urea and reagent to observe a diagnostic color change.

Gastric Ulcer (GU) Demographics

Characterized by peak incidence between $40\text{--}60\,\text{years}$ of age, an equal distribution between sexes ($\text{Male} = \text{Female}$), and negative genetic predisposition.

Duodenal Ulcer (DU) Demographics

Characterized by peak incidence between $20\text{--}40\,\text{years}$ of age, a male predominance with a ratio of $3:1$, and a positive genetic association with blood group O.